摘要
目的比较胸部开放伤后胸腔海水与淡水浸泡对肺损伤的作用。方法24只实验犬致胸部开放伤后分成对照组、海水组和淡水组。海水组和淡水组伤后10min内经伤口分别灌入海水和淡水;观察胸部开放伤后0、2、4、6、8h的生命体征,测渗透压、血浆炎症因子变化。伤后8h取肺组织观察病理学和炎症因子变化。结果肺泡通透指数:海水组较淡水组明显升高(P<0.05),淡水组与对照组比较无统计学差异(P>0.05);IL-1β、IL-8:海水组较淡水组升高(P<0.05),淡水组较对照组升高(P<0.05);血管性血友病因子(von Willnbrang factor,vWf):海水组较淡水组、对照组升高(P<0.05),淡水组较对照组无差异。相关分析显示:血浆渗透压与肺泡通透性指数、炎症因子IL-1β、IL-8正相关(P<0.05)。结论海水较淡水对开放伤后肺组织的损伤程度更严重,可能与海水高渗加重肺血管通透性和过度炎症反应有关。
Objective To compare the differences between acute lung injury ( ALI) induced by seawaterimmersion and freshwater-immersion after open chest trauma. Methods Twenty-four dogs were randomly divided into 3 groups,ALI model group ( control) ,seawater immersion group ( group SW) ,and freshwater immersion group ( group FW) . ALI model was established by cutting an incision of 0. 5 cm at the 4th intercostal space. Then artificial seawater or pure water ( 35 ml/kg) was perfused into the incision for the later 2 groups. The pathological changes were evaluated by light microscopy,hemotoxin and eosin ( HE) staining in 8 h after perfusion. In 0,,4,6 and 8 h after trauma,the plasma samples were collected to test the levels of IL-1β, IL-8 and von Willnbrang factor ( vWF) with ELISA. The amount of total protein in plasma and bronchoalveolar lavage fluid ( BALF) were measured. Results Compared with group FW,the pulmonary penetration index, the concentrations of IL-1β,IL-8 and vWF in the plasma and lung tissue in group SW were markedly higher. They were significantly positively correlated with the plasma osmotic pressure ( P〉0. 05) . Conclusion Despite immersing in seawater and in freshwater worsen the ALI after open chest trauma,the ALI induced by seawater-immersion is severer than that caused by freshwater-immersion. It is attributed to higher plasma osmotic pressure and abundance of salts after seawater immersion,which increasing the pulmonary penetration index and aggravating the inflammatory response.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2009年第21期2090-2093,共4页
Journal of Third Military Medical University
基金
海军后勤科研计划课题(2004-3304)~~
关键词
急性肺损伤
淡水
海水
胸部开放伤
浸泡
acute lung injury freshwater seawater open chest trauma immersion